Health in South Korea

South Koreans enjoy the right to universal healthcare, ranking first in the OECD for healthcare access.^[1] Satisfaction of healthcare has been consistently among the highest in the world - Korea ranked as having the world's sixth best healthcare system in 2016 by Numbeo, substantially ahead of Germany, Sweden, the UK, Australia, Canada or the USA.^[2]

Quality of healthcare has been among the world's best - Korea had the OECD's highest colorectal cancer survival rate at 72.8%, significantly ahead of Denmark's 55.5% or the UK's 54.5%. It ranked second in cervical cancer survival rate at 76.8%, signficantly ahead of Germany's 64.5% or the USA's 62.2%.^[3] Hemorrhagic stroke 30 day in-hospital mortality per 100 hospital discharges was the OECD's third lowest at 13.7 deaths, which was almost twice as low as the USA's 22.3 or France's 24 deaths. For Ischemic stroke, it ranked second at 3.4 deaths, which was almost a third of Australia's 9.4 or Canada's 9.4 deaths.

Korean hospitals have one of the world's most advanced medical equipment and facilities readily available, ranking 4th for MRI units per capita and 6th for CT scanners per capita in the OECD.^[4] It also had the OECD's second largest number of hospital beds per 1000 people at 9.56 beds, which was over triple that of Sweden's 2.71, Canada's 2.75, the UK's 2.95 or the USA's 3.05 beds.

Obesity has been consistently among the worlds' lowest - Only 3% of the population were obese, which was the second lowest in the OECD, compared to over 30% in the USA or 23% in the UK.^[5] As a result, mortality from cardiovascular disease was the fourth lowest in the OECD.^[6] Young Korean males were found to be the tallest in all of Asia, resulting from healthy living conditions, economic development and changes in food culture.^[7]

Life expectancy has been rising rapidly and Koreans today have one of the world's longest life expediencies, tied 11th with Norway in the OECD at 81.8 years in 2013, with female life expectancy in particular ranking 5th in the world at 85 years.

Korea ranked highest in influenza vaccination in Asia at 311 vaccines per 1,000 people. This is the result of free influenza vaccination offered to everyone over 65 and for everyone else, the price being affordable at around 20~30 USD.^[8]

Chronic disease

According to the Ministry of Health and Welfare, chronic illness account for the majority of diseases in South Korea, a condition exacerbated by the health care system’s focus on treatment rather than prevention. The incidence of chronic disease in South Korea hovers around 24 percent. The human immunodeficiency virus (HIV) rate of prevalence at the end of 2003 was less than 0.1 percent. In 2001 central government expenditures on health care accounted for about 6 percent of gross domestic product (GDP).^[9] South Korea is experiencing a growing elderly population, which leads to an increase in chronic degenerative diseases. The proportion of the population over 65 is expected to rise from 13% in 2014 to 38% in 2050. Majority of health care professionals treat patients on curative, rather than preventive treatments, because of the lack of financial incentives for preventive treatments.^[10]

Health insurance system

South Korea has universal health insurance, which started in July 1977. All medical societies were merged into the National Health Insurance Service in 2000. Nearly all South Koreans are beneficiaries of the program, therefore almost reaching the goal of providing health insurance for all South Korean citizens. The insurance is funded by contributions, government subsidies, and tobacco surcharges and the National Health Insurance Corporation is the main supervising institution. The program is fair in practice; it gives the same amount of medical expenses and reimbursements for all citizens, regardless of how much they are paid. It administers longer term care services for the elderly.^[10] The National Health Insurance started to develop deficits starting in 1996, when the total health expenditures exceeded the total income. The government has been raising the insurance premiums to make up for the deficit, but many health policy experts predict that the increase will not solve the deficit.^[11] About 54% of health expenditure is met by the National Health Insurance Service. The remaining 46% is mostly met by out of pocket contributions. Healthcare expenditure is around 7.2% of GDP, and has increased from $64 billion in 2009 to $113 billion in 2015.^[12]

Hospitals

The number of hospital beds per 1000 population is 10, well above the OECD countries' average of 5.^[13] According to Mark Britnell hospitals dominate the health system. 94% of hospitals (88% of beds) are privately owned. 30 of the 43 tertiary hospitals are run by private universities. 10 more are run by publicly owned universities. Payment is made on a fee-for-service basis. There is no direct government subsidy for hospitals. This encourages hospitals to expand and discourages community services. ^[14]

The Korea International Medical Association has been formed to encourage medical tourism. The Korea Times reported in a series of articles that Korean hospitals have a discriminatory pricing policy, charging foreigners two to three times more than the full-fee for locals.^[15] The paper revealed that the price disparity in medical fees for foreign patients is extremely high, considering that the difference between the lowest and highest fees for the most-sought-after procedures exceeds more than 10 times on average.^[16] It claimed the government is overlooking soaring medical fees on foreign patients, who are unprotected from malpractice, discriminatory charging, overpricing and patient privacy rights under the Korean Medical Law.^[16][17]

Unequal distribution of physicians

There are regional disparities between urban and rural areas for health professionals. The number of primary care doctors in cities is 37.3% higher than rural areas, and the problem is growing because younger physicians are choosing to practice in the cities.^[18]

References